Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | N2509 | TX |
Y | 208000000X | Pediatrician | N2509 | TX |
NPI | 1013113034 |
---|---|
Provider Name | Stephanie Freeman |
First Address | Houston, TX 77030-2809 |
Second Address | Houston, TX 77030-2809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2007 |
Last Update Date | 09/07/2009 |